INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-I: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
Arapaho-Roosevelt National Forest Transportation System Alternatives Study | 0596-New | |||||||||||||||
DATE PREPARED | ||||||||||||||||
April 8, 2013 | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
NOTE: The per response time for each of the following four site surveys includes approximately 1 minute to read initial contact script and 10 minutes to complete the survey. | ||||||||||||||||
Brainard Lake Recreation Area | None | 300 | 1.00 | 300.00 | 0.18 | 54.99 | 0.00 | $23.41 | $1,287.32 | |||||||
Indian Peaks Wilderness | None | 300 | 1.00 | 300.00 | 0.18 | 54.99 | 0.00 | $23.41 | $1,287.32 | |||||||
Guanella Pass | None | 300 | 1.00 | 300.00 | 0.18 | 54.99 | 0.00 | $23.41 | $1,287.32 | |||||||
Mount Evans Recreation Area | None | 300 | 1.00 | 300.00 | 0.18 | 54.99 | 0.00 | $23.41 | $1,287.32 | |||||||
Non-respondents is estimated at 125 for each location for a total of 500 | None | 500 | 1.00 | 500.00 | 0.02 | 8.34 | 0.00 | $23.41 | $195.12 | |||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
SUBTOTAL | 1,700.00 | 228.30 | 0.00 | 0.00 | $5,344.39 | |||||||||||
TOTAL OF ALL PAGES | 1,700.00 | 228.30 | 0.00 | 0.00 | $5,344.39 | |||||||||||
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 1,700.00 | 228.30 | ||||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0563-New | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | $0.00 | |||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0563-New | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | $0.00 | |||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0563-New | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | $0.00 | |||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0563-New | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0563-New | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | |||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |